Lactate Dehydrogenase (LDH) Lab Values

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Abby Rose
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Outline

Objective:

Determine the significance and clinical use of LDH levels in clinical practice

 

Lab Test Name:

Lactate Dehydrogenase – LDH

 

Description:

LDH is important in making the body’s energy and is present in almost all of the tissues in the body such as the heart, lungs, blood, kidneys, and brain. 

When these tissues experience damage, the enzyme is released into the bloodstream or other body fluids.

 

Indications:

LDH is drawn to evaluate hemolysis, such as when patients are placed on ECMO or in some forms of anemia. 

It is also used to determine the presence of ischemia as those with cardiac cell damage will experience.

 

Normal Therapeutic Values:

Normal – 

  • 88-230 U/L

Collection:

  •  Plasma separator tube

 

What would cause increased levels?

Conditions that can cause increased LDH:

  • Liver disease
  • Pancreatitis
  • Anemia
  • Myocardial infarction
  • Bone fractures
  • Muscle trauma
  • Cancers
  • Infections 
    • encephalitis, bacterial meningitis, and HIV

 

What would cause decreased levels?

Typically, LDH deficiency is very rare, and usually not considered harmful.

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Transcript

Hey everyone, Abby, here from nursing.com. This lesson will discuss lactate dehydrogenase. We’ll talk about the normal levels and conditions that might increase or decrease its value. Let’s get started. 

 

Lactate Dehydrogenase or LDH, is a lab that measures the amount of LDH in the blood. LDH is present in almost every single tissue in the body. It gets released into the bloodstream when that tissue becomes damaged. We see that with myocardial infarction. 

 

Some clinical indications for having this lab drawn are in cases of hemolysis. I used to work with ECMO patients and through the oxygenator, as those cells would go through the motor and the whole circuit and everything, sometimes they would get really chewed up, and it was evidence of a lot of hemolysis, and so we would use that LDH value to tell us just how much that might be happening. It’s also indicated for patients with hemolytic anemia. It’s also going to be drawn to evaluate for ischemic organ damage like we talked about on that first slide. You can see here, after an MI, this section of tissue that became ischemic and died. Normal therapeutic values are between 88 and 230 units per liter. It’s collected in a plasma separator tube like this green top. 

 

When blood values are increased in LDH, that can indicate liver disease and pancreatitis. We talked about hemolytic disorders and myocardial infarction, but also bone fractures, muscle trauma, and let’s not forget anaerobic metabolism. It’s also one of the standard labs that are drawn when tumor lysis syndrome is suspected. In infections like encephalitis, bacterial meningitis, and HIV, an LDH value will also be increased. Now, it’s not very typical for there to be an LDH deficiency. It’s pretty rare and it’s not considered harmful or related to any disease process so, that’s some good news. LDH is an enzyme or byproduct of tissue damage that can be seen in anaerobic metabolism, hemolysis, MI, pancreatitis, liver, heart, brain, all of these various tissue diseases, right? It’s an indication of ischemia or damage. Normal values are between 88 and 230 units per liter. When it’s decreased, that’s pretty rare and unrelated to a disease process. 

 

Now, you all did great, and this wraps up our lesson on lactate dehydrogenase. Remember, we love you guys, now go out and be your best self today and as always, happy nursing.

References:

 

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Concepts Covered:

  • Cardiac Disorders
  • Cardiovascular
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock
  • Shock
  • Disorders of Pancreas
  • Endocrine
  • EENT Disorders
  • Adult
  • Medication Administration
  • Acute & Chronic Renal Disorders
  • Respiratory Emergencies
  • Newborn Complications
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Immunological Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Vascular Disorders
  • Microbiology
  • Respiratory Disorders
  • Depressive Disorders
  • Oncology Disorders
  • Noninfectious Respiratory Disorder
  • Nervous System
  • Central Nervous System Disorders – Brain
  • Substance Abuse Disorders
  • Intraoperative Nursing
  • Emergency Care of the Trauma Patient
  • Integumentary Disorders
  • Integumentary Disorders
  • Urinary System
  • Liver & Gallbladder Disorders
  • Eating Disorders
  • Pregnancy Risks
  • Cardiovascular Disorders
  • Terminology
  • Disorders of Thermoregulation
  • Basics of NCLEX
  • Multisystem
  • Upper GI Disorders
  • Studying
  • Neurological Emergencies
  • Postpartum Complications
  • Infectious Respiratory Disorder
  • Renal Disorders
  • Communication
  • Perioperative Nursing Roles
  • Oncologic Disorders
  • Musculoskeletal Disorders
  • Prenatal Concepts
  • Muscular System
  • Proteins
  • Sexually Transmitted Infections
  • Peripheral Nervous System Disorders
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
03.03 Hypoglycemia for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
Acetaminophen (Tylenol) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Addicted Newborn
Adenosine (Adenocard) Nursing Considerations
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advanced Cardiovascular Life Support (ACLS)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Amputation for Certified Emergency Nursing (CEN)
Anemia for Progressive Care Certified Nurse (PCCN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Anti Tumor Antibiotics
Anti-Infective – Antifungals
Anti-Infective – Fluoroquinolones
Antidepressants
Antidepressants
Antineoplastics
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Autonomic Nervous System (ANS)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
AVPU Mnemonic (The AVPU Scale)
Benzodiazepines
Blood Flow Through The Heart
Blood Pressure (BP) Control
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Blunt Thoracic Trauma
Body System Assessments
Brain Natriuretic Peptide (BNP) Lab Values
Bronchodilators
Burns for Certified Emergency Nursing (CEN)
Calcium Acetate (PhosLo) Nursing Considerations
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Calcium Carbonate (Tums) Nursing Considerations
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Disease in Pregnancy
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Cerebral Metabolism
Chemotherapy Patients
Cirrhosis for Certified Emergency Nursing (CEN)
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Creatine Phosphokinase (CPK) Lab Values
Critical Thinking
Cushing’s Syndrome Case Study (60 min)
Day in the Life of a Med-surg Nurse
Day in the Life of a NICU Nurse
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Digoxin (Lanoxin) Nursing Considerations
Disease Specific Medications
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis Case Study (45 min)
Endocarditis for Certified Emergency Nursing (CEN)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
Flight Nurse
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Goal Setting
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Hemodynamics
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Hiatal Hernia
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hyperemesis Gravidarum for Certified Emergency Nursing (CEN)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertensive Crisis Case Study (45 min)
Hyperthyroidism Case Study (75 min)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypoparathyroidism
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Hypovolemic Shock Case Study (OB sim) (60 min)
Influenza for Certified Emergency Nursing (CEN)
Intake and Output (I&O)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Invoicing Process
Lactate Dehydrogenase (LDH) Lab Values
Leukemia
Lorazepam (Ativan) Nursing Considerations
Lung Cancer
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Marfan Syndrome
Maternal Risk Factors
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Musculoskeletal Terminology
Myocardial Infarction (MI) Case Study (45 min)
Myoglobin (MB) Lab Values
Neurogenic Shock for Certified Emergency Nursing (CEN)
Newborn Physical Exam
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Norepinephrine (Levophed) Nursing Considerations
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis